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RESEARCH

General anaesthesia boosts dementia risks

General anaesthesia for the elderly boosts the risks of dementia by more than a third, according to a study by French doctors released on Friday.

Researchers led by Francois Sztark at the University of Bordeaux in southwestern France analysed data from a long-term study into cognitive decline covering 9,300 elderly people in three French cities.

The volunteers — average age 75 — were interviewed when they were recruited into the study and then two, four, seven and 10 years afterwards.

The data showed a link between the onset of dementia and a general anaesthetic that had been administered two or three years before.

Those who had received general anaesthesia were 35 percent likelier to develop dementia symptoms by the next follow-up interview compared with counterparts who had not had general anaesthetic.

Previous work has already highlighted a condition called post-operative cognitive dysfunction, or POCD, in which an elderly patient who undergoes major surgery also goes into mental decline relatively soon afterwards.

The reasons for this, though, are unclear. Some experiments suggest that various anaesthetics inflame neural tissues, causing protein plaques and tangles to develop that are precursors of Alzheimer's disease.

The research was released at a congress in Barcelona, Spain, of the European Society of Anaesthesiology.

"These results are in favour of an increased risk for dementia several years after general anaesthesia," Sztark said in a press release, adding that patients who underwent major surgery needed long-term support.

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HEALTH

France to ban vaginal exams without consent

France has moved to ban vaginal and rectal exams on unconscious patients after a study found that many were being performed without patient consent.

France to ban vaginal exams without consent
One in three pelvic examinations by first-year students are carried out without consent. Photo: AFP
It might sound like common sense, but France is set to put an end to the practice of doctors and their students carrying out rectal and vaginal examinations on patients who haven't expressly given their permission. 
 
The reason? It was revealed that some doctors have been using patients under general anesthetic as teaching tools for their students. 
 
While doctors claimed it was simply medical teaching, others were outraged that male and female patients hadn't given their permission. 
 
Among the most vocal were a group of fifty doctors, feminists, and social workers, who wrote an open letter to the French government in February demanding a change to the system. 
 
The group noted that medical directors had been quoted as saying they didn't ask for permission because patients “might say no”, or even that it was “preferable” that the patients “don't remember that people unknown to them have 'had a look'”.
 
Women's rights group Osez Le Féminisme said the examinations met the legal definition of rape in that they were “An act of sexual penetration committed on another, either by violence, restraint, threat or surprise”. 
 
One former student doctor told L'Express that she remembered carrying out gynocology exams on unconscious patients at a Paris clinic. 
 
“Before the operation, we were told we could make a vaginal examination when the patient was asleep. We all took turns without asking any questions,” she said.
 
In response to the revelations, Health Minister Marisol Touraine asked for an official report to be carried out by teaching hospital medical deans, who came back with troubling figures. 
 
They said no patient consent had been obtained for for one in three pelvic examinations by first-year students, or one in five such procedures carried out by more experienced students. 
 
Touraine said the report was “very worrying” and “condemned with the utmost firmness these illegal practices”.
 
“The state will be extremely firm against these unacceptable practices which undermine the integrity of the human body and the human rights of patients,” she said in a statement
 
The minister added that new measures would be taken to ensure no one in France would be examined by third parties if they hadn't given prior permission. 
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